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HomeMy WebLinkAbout0205 PALOMINO DRIVE - Health L alomino Drive le 7 048 �e 0 LOCATION SEWAGE PERMIT NO. VILLAGE INSTAALER'S NAME 6 ADDRESS KAof R U1LDER OR OWNER b DATE PERMIT ISSUED DATE C0MPLIIANCE ISSUED / Z - LOdlBy I` . . 1 N1, 4<< No.'..... O:. Fes$......�........_...... THL* COMMaONWEALTH OF MASSACHUSETTS / BOAR® OF HEALTH Appliratiou for Bispnsal Morks Taustrur#iou Frrutit -- Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at - _ . 2pc� Pf� i r� - ......._•----------------------•. ------•------ O � .._......._.._......._........_. • ........ - ........................... .........__. __ ocation- ss 119.. - Plc,? ..................................... l`QQ`1 !_�'Cz.?_ � fiP �[ 1 ow Addr ss Installer Address U Type of Building Size Lot__41;_7 a.7_Sq. feet T Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) `4 Other—Type of Building� YP g ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Other,fixtures .---•-•••••-•-•-•-•----••----••-• ••-----••--••-•--••••••-----••-••--•---•••••••••--••-••-•••-•••••••-•-•--•••-•---•-••-•••....-•-•-•-•..._-•---• W Design Flow........... ______________________gallons per person per day. Total daily flow_________-ii� Q_____.._____________gallons. WSeptic Tank—Liquid ca.pacityf®aQ__.gallons Length___.__..... Width.....4...... Diameter________________ Depth____4!__.-- x Disposal Trench—No_ ____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------- ---------- Diameter._._. Depth below inlet..... ....... Total leaching area5.ad_t_:49q-+x-. P b Z Other Distribution box (><j Dosing tank ( ) aPercolation Test Results Performed by_.L� ___. .._G �-���'�,.__.__� _.__. Date__ �� J-4--..,SA-------- Test Pit No. 1._:<.Z....minutes per inch Depth of Test Depth to ground water6��e_AAJ__-' C-c.-P )AJ'M;'P-Cb fs, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ -----------•---•----------------------------------------------- •...... ---------------- ------------------- O Description of Soil x --•••••--•••`-5� ------13X-IA-9�A-�P-•----•--��f�/j.............................................................. W U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ------------------------------------------•----------•----•------------•--....-----------......._..----•----------------------------------------------•----------•---------•-••••••-••-........•••----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITI:j 5 of the State Sanitary Code— The undersigned further agrees not to place th syste in operation until a Certificate of Compliance has been s e by�rd of lth. !� g $ r Application Approved By......... .......�• > - ................... Date Application Disapproved for th following reasons---------------------•------••--------------------------------------------•------•-------------------....-•------ ........................................................•-----•--•••......_..-••._...--•--•---......-••--••-•-•-----------------•-------•-•••-•--•••-•••----•-•--•-••••-•---•••--•-•••••••••••••------- Date PermitNo......................................................... Issued....................................................... Date v . wNo------------------------ Fizz............................_ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH J ApplirFa#ion for Dhip u al Work,5 Tonstrurtinn Frrutit Application is hereby made for a Permit to Construct ) or Repair ( } an Individual Sewage Disposal System at: Rf �� '- - .....---•----...__......................•-•---..... -. --t...•------•-------..._..••---_... --•-••--.---- -•------•-•-••-•-•--•--•--...___....... ._ ..... L c ion-A .... .�h�.. ------. ..... _.-r1fi r .. �r .2'..._.. . dd ........................................ r _.1 ......Cr. !��11Z.x.-........ Installer Address ��-,�� q- Type of Building Size. Lot----.--_ ............7....S feet �-1 Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building No. of persons............................ Showers � yP g ---------------------------- -------- ----(- -)•-- Cafeteria----------------------------- Design Other fixtures ---------------------------------------• •---•--•••----•-•------••-•.........-•-•••---•--.... • . Flow..........."�'...�..........................gallons per person per day. Total daily flow--------- gal W --------•---------•----. Ions. WSeptic Tank—Liquid capacit}�2`?!!�__gallons Length..._------ Width__.." ......_ Diameter________________ Depth.... ...... x Disposal Trench—No. .................... Width.................... Total Length_._............... Total leaching area....................sq. ft. �. Seepage Pit No......../----------- Diameter.... Depth below inlet_._41...._._.___ Total leaching area5�*',!_° tl"ft6 z Other Distribution box (K!) Dosing tank ( ) Percolation Test Results Performed by z_a G�.. ....r .... . ... Date.:� z 4 aTest Pit No. I-:!?._...minutes per inch Depth of Test Pit '_ _..._.__ Depth to ground watel-lor el 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 04 ---------------------------------------------------------------•--------- .............................................................. O Description of Soil...................... "'• -�'--......19?"�r:eq.��_��------�C.......................................................................... x U w U Nature of Repairs or Alterations—Answer when applicable._.............................................................................................. ---............................................................-------------------------•--------•••••---..........•------•----••---•---•-•--••-••--•--•---•-•-•-•-•-•••-•--•----•-••-'•---•-•------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Com nce has bee sue by th boar of health Signed: = 1! 1 _.... Ij ate ApplicationApproved By...... -•.............••-••---••--•••-••----------....•••-•---•-•-----------------•-•-••-••----- Date Application Disapproved for the following reasons---------------------------------------------------------------•-•---------------•------------...------•----•-- ......................................................................................................................................................................................................... Date PermitNo.......................................................... Issued....................................................... Date THE COMMONWEALTH H OF MASSACHUSETTS _ BOARD OF HEALTH ..........................................OF............ ..................................•-•---.............•-•--•............ �' if it f n uut �i�inrr ~ THIS h S du a Disposal System constructed ( ) or Repaired ( ) by................................................... ... --•---•------•---•......---------••----•.......--•-'.....-----••......----•-•--•-•......----•-. Installer at........................................................................................... ------------- has been installed in accordance with the provisions of 1a of The State Sanitaf" in the application for Disposal Works Construction-Permit No..,*-,-,,,___...•.......................... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..............•-•---•-•-••-•-•-------------.......-•----•-••----------- .._... Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS ' t..-�� BOARD OF HEALTH ........................... ............OF. -.- :.. ..................._._....._.......................................... No................::..:.... FEE........................ Permission ' e rad/y/ d to Construct ) or,, epair ( ) an ivl,ua S rage Disposal Systems atNo............................. --------------------------------------------------------------------------. .--- ... -------------------------•--•-----------------------•---....... as shown on the application for Disposal Works Construction No..................... Dated.......................................... -• ....... --•-•------•-----...•-•--------•--•--•-•----------•------••••----••-----••......-'---_...._ Board of Health DATE................................ ................................................ FORM 1255 A. M. SULKIN, INC., BOSTON i } , - - -- -- - 4 I I 95,oo ------- -� t H0)21Z_ SCi9LE- - / ' = iO —__ .__ __..__ T I < � --- - i/ E ,2 %. SC -4LE 9rouncd Profile /2 " OF Ft�. l5f-lE � G,2ADE . SC HEPJ. 4O V C. CO2 r EQUfaL � S PT/c �rninirnc�rr� �.. per- fop-t-� 2 of /e - �2 wasf->e JAJ D/57- Box o (1 0 2 Ole 3/4'-/Ye /000 (SAL__SEPT/C Tf3hJK f► LtJa S h e d S`f O r'n� � ° • o 0 93.E 94.4 99 DE- TI ! L S SCr�� E „ _ / 1 ©„ 1/-E-/19CH )E":->I -r p E ,jG f%J -_ ---- / G (5 7— Q L G C..._ 0 G-7 —i G� J Z g.E D,E? a oM HOUSE- C/no DATE _ LU l�EL�E 1�.1G d�sPos�r� w t-rNE S S _. --- - - 'E,eC A,TE c -- / /A/. /ti/CH a: 7 � ` � �� vt ►a2.3 ,00 .Z , Low l2RT� _ZZO GALS./D,9Y DA-rum V / / \�i (Z �o► 4P 5 P T i c - -i4 ti K 2 2 O _ )< i 5x 250 TE s T HOLE 4*J T E S 0 L E 2 Q_ GAL. THtI/k: P/7— (9 0 io3 to tl� �0 S. �J S/DC- ln/faLL =LEI F G ��, � = �9' Pam. 4 -? J7 - (� p B O? TOM �3� '�' S F �! , O Q 7-07-r9 L 4 G �ULEr9CH T 0^ 3.S 104 .0 SA�va 104 .P /44 " i / GE,2T/F Y T/-/AT THE BU/L DIAJG / G E- Q / - _ - � -' F'i20P05E'D OrV THE G�OU/�JD �5 S ri o w N O N -r-/-// S ,�>L ,Q tv ZD O E s �c �_ o f 9� F�L "9,Q 2 S o P/q c =� COA/F0�2/ To THE SU/L Z)/AJ6 SET- �14, L/ M l �`U Z'�/ V � BAiCK �E'EQC//+E'EM, �/TS OF THE Town-J I F�,e E P f3 2 C=- ZD FCO,2., H 1I.AJ ,-1 f1 f--( C` fc tD 5 . of � S 5 N 0 A-) T E_ �? F-',�2/ �.--1�+ / 9 64 �EP�S or -- �' A' RfTi�+ �4 E�ERET 1=1 4*fNCKtEY' T l t HIKKtfr i� 23G y \,F 17$7 ` sT a ���/ Nc sT���p�/ Osok LOIN/ E I� E7LLE- Inc . NAI O. 00 e xi5-t-tnc� cl� vcxfron BLDG SErf3f�C,� a o p Proposed e /e vGfiOn A2E QU/,2E-/-7EA/TS . — _ S t